Basic Information
| Provider Information | |||||||||
| NPI: | 1790928125 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAMARITAN LEBANON COMMUNITY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 525 N SANTIAM HWY | ||||||||
| Address2: | |||||||||
| City: | LEBANON | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973554363 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 525 N SANTIAM HWY | ||||||||
| Address2: | |||||||||
| City: | LEBANON | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973554363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412582101 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2009 | ||||||||
| LastUpdateDate: | 04/15/2009 | ||||||||
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| AuthorizedOfficialLastName: | COX | ||||||||
| AuthorizedOfficialFirstName: | RANDY | ||||||||
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| AuthorizedOfficialTitleorPosition: | REHABILITATION SERVICES MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5414517158 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | R.T. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | 5684 | OR | Y | Hospitals | General Acute Care Hospital | Critical Access |
No ID Information.